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Medicines (Prescription Only) (Jersey) Order 1997

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MEDICINES (PRESCRIPTION ONLY) (JERSEY) ORDER 1997 Revised Edition 20.625.95 Showing the law as at 1 January 2019 This is a revised edition of the law Medicines (Prescription Only) (Jersey) Order 1997 Arrangement MEDICINES (PRESCRIPTION ONLY) (JERSEY) ORDER 1997 Arrangement Article 1 Interpretation ................................................................................................... 5 2 Prescription only medicines ............................................................................ 7 3 Medicinal products that are not prescription only medicines ......................... 8 4 New medicinal products ................................................................................. 9 5 Appropriate practitioner .................................................................................. 9 6 Conditions for prescriptions relating to sale and supply ................................. 9 6A Conditions for prescriptions – administration ............................................... 11 7 Exemption for highly diluted medicinal products ........................................ 11 8 Exemptions for specified categories of persons ............................................ 11 9 Exemption for emergency sale or supply...................................................... 12 10 Exemption for sale or supply in hospitals or the prison................................ 14 11 Exemption for authorised needle supply services ......................................... 14 12 Exemption for sale or supply in cases involving another’s default .............. 14 13 Exemption in the case of forged prescription ............................................... 14 14 Exemption for parenteral administration to human beings ........................... 14 15 Exemption for non-parenteral administration to human beings ................... 15 16 Citation .......................................................................................................... 15 SCHEDULE 1 16 PART 1 16 PRESCRIPTION ONLY MEDICINES 16 PART 2 69 PART 3 70 NAMED PRODUCTS THAT ARE NOT PRESCRIPTION ONLY MEDICINES 70 TABLE A 70 Revised Edition – 1 January 2019 Page - 3 20.625.95 Arrangement Medicines (Prescription Only) (Jersey) Order 1997 TABLE B 71 PART 4 72 OTHER MEDICINAL PRODUCTS THAT ARE NOT PRESCRIPTION ONLY MEDICINES 72 SCHEDULE 2 85 EXEMPTION FOR CERTAIN PERSONS FROM ARTICLE 57(2) OF THE LAW 85 PART 1 85 PART 2 89 PART 3 91 SCHEDULE 3 94 SUBSTANCES THAT MUST NOT BE CONTAINED IN A PRESCRIPTION ONLY MEDICINE EXEMPTED BY ARTICLE 9 94 SCHEDULE 4 95 CLINICAL MANAGEMENT PLAN 95 1 Information to be included in clinical management plan ............................. 95 Supporting Documents ENDNOTES 96 Table of Legislation History ........................................................................................ 96 Table of Renumbered Provisions ................................................................................. 96 Table of Endnote References ....................................................................................... 98 Page - 4 Revised Edition – 1 January 2019 20.625.95 Medicines (Prescription Only) (Jersey) Order 1997 Article 1 MEDICINES (PRESCRIPTION ONLY) (JERSEY) ORDER 19971 THE HEALTH AND SOCIAL SERVICES COMMITTEE in pursuance of Articles 57 and 110 of the Medicines (Jersey) Law 19952, after consultation with the Medicines Advisory Council and having otherwise complied with Article 110 of the Law, orders as follows – Commencement [see endnotes] 1 Interpretation (1) In this Order, unless the context otherwise requires – “aerosol” means a product that is dispersed from its container by a propellent gas or liquid; “controlled drug” has the same meaning as it has in Article 3 of the Misuse of Drugs (Jersey) Law 19783; “cyanogenetic substances” means preparations – (a) that are presented for sale or supply under the name of, or as containing, amygdalin, laetrile or vitamin B17; or (b) that contain more than 0.1% by weight of any substance having the formula α-cyanobenzyl-6-O-ß-D-glucopyranosyl-ß-D- glucopyranoside or α-cyanobenzyl-ß-D-glucopyranosiduronic acid; “dosage unit” means – (a) where a medicinal product is in the form of a tablet or capsule or is an article in some other similar pharmaceutical form, that tablet, capsule or other article; and (b) where a medicinal product is not in any such form, the quantity of the product that is used as the unit by reference to which the dose is measured; “external use” means application to the skin, hair, teeth, mucosa of the mouth, throat, nose, ear, eye, vagina or anal canal, when a local action Revised Edition – 1 January 2019 Page - 5 20.625.95 Article 1 Medicines (Prescription Only) (Jersey) Order 1997 only is intended and extensive systemic absorption is unlikely to occur; but does not mean application by means of a throat spray, throat pastille, throat lozenge, throat tablet, nasal drop, nasal spray, nasal inhalation or teething preparation; “health prescription” means a prescription described in Article 15(2) of the Health Insurance (Jersey) Law 19674; “health record” has the same meaning as in the Data Protection (Jersey) Law 20185; “inhaler” does not include an aerosol; “Law” means the Medicines (Jersey) Law 19956; “master” has the same meaning as it has in the Merchant Shipping Act 1894 of the United Kingdom; “maximum daily dose” or “MDD” means, in relation to a substance contained in the amount of a medicinal product for internal use, the recommended maximum quantity to be taken or administered in a period of 24 hours; “maximum dose” or “MD” means, in relation to a substance contained in the amount of a medicinal product for internal use, the recommended maximum quantity to be taken or administered at any one time; “maximum strength” means such of the following as may be specified – (a) the maximum quantity of a substance by weight or volume contained in a dosage unit of a medicinal product; (b) the maximum number of units of activity contained in a dosage unit or a weight of a medicinal product; and (c) the maximum percentage of a substance contained in a medicinal product calculated in terms of weight in weight, weight in volume, volume in weight or volume in volume, as appropriate; “medicinal product” does not include a veterinary drug; “occupational health scheme” means a scheme in which a person in the course of a business carried on by him or her provides facilities for his or her employees, for the treatment or prevention of disease; “operator”, in relation to an aircraft, means the person for the time being having the management of the aircraft; “parenteral administration” means administration by breach of the skin or mucous membrane; “prescription only medicine” means a medicinal product that is specified by this Order as a prescription only medicine; “registered optometrist” has the same meaning as it has in Article 1(1) of the Opticians (Registration) (Jersey) Law 19627; “repeatable prescription” means a prescription containing a direction that it shall or may be dispensed more than once; “soaps” means any compounds of a fatty acid with an alkali or amine; Page - 6 Revised Edition – 1 January 2019 20.625.95 Medicines (Prescription Only) (Jersey) Order 1997 Article 2 “state registered paramedic” means a person who is registered in the register established and maintained under section 60 and paragraph 1(a) of Schedule 3 to the Health Act 1999 of the United Kingdom; “supplementary prescriber” means an appropriate practitioner referred to in Article 5(d), (e) or (f) whose entry on the register established and maintained under article 5 of the Nursing and Midwifery Order 2001 of the United Kingdom, as referred to in the Health Care (Registration) (Prescribed Qualifications) (Jersey) Order 20038, indicates that he or she is, or may act as, only a supplementary prescriber; “unit preparation” means a preparation (including a mother tincture) that is prepared by a process of solution, extraction or trituration, with a view to being diluted tenfold or one hundredfold (either once or repeatedly) in an inert diluent and then used either in that diluted form or (where applicable) by impregnating tablets, granules, powders or other inert substances.9 (2) In this Order – (a) in Schedules 1 and 2, the following abbreviations are used – “g” for gram; “iu” for international unit of activity; “mcg” for microgram; “mg” for milligram; and “ml” for millilitre; and (b) in Schedule 1 – (i) entries in any of columns 2, 3 and 4 of Parts 1 and 2 relate only to the substances specified in column 1 against which they appear, (ii) where, in relation to a particular substance specified in column 1, an entry in any of columns 2, 3 and 4 bears a number or letter, that entry relates only to entries in the other of columns 2, 3 and 4 that bear the same number or letter, and (iii) the entries in column 4 of Part 1 shall be read subject to the note at the end of that Part. (3) Without prejudice to Article 10 of the Interpretation (Jersey) Law 195410, every provision in the Medicines (Jersey) Law 199511 that relates in any other way to its interpretation shall also apply in the same way to this Order, unless the context otherwise requires. 2 Prescription only medicines The following descriptions and classes of medicinal products are specified for the purposes of Article 57(1)(a) of the Law, and are accordingly prescription only medicines, namely – (a) medicinal products that consist of or contain a substance specified in column 1 of Part 1 of Schedule 1 to this Order; Revised Edition – 1 January
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  • Management of Breathlessness in Patients with Life Limiting Disease

    Management of Breathlessness in Patients with Life Limiting Disease

    MANAGEMENT OF BREATHLESSNESS IN PATIENTS WITH LIFE LIMITING DISEASE Helen Armstrong Dr Helen Bonwick Dr Clare Jeffries Dr Martin Ledson Dr Kate Marley Mrs Sue Oakes CURRENT STANDARDS AND GUIDELINES • Current standards and guidleines • Literature review – pharmacological and non- pharmacological • Audit results • Proposed new standards and guidelines • Current management of cough Guidelines Non pharmacological options (Level 4 ) • These are important and should not be overlooked. They may be used alone or in conjunction with medication. • They include – Reassurance and explanation – Use of fan or cool air across face – Adequate positioning of the patient to aid breathing – Breathing exercises and relaxation training – Advice on modifying lifestyle – Acupuncture, aromatherapy and reflexology Guidelines Pharmacological options Benzodiazepines (Level 3) • Benzodiazepines may be useful especially if there is coexisting anxiety and/or fear. • Lorazepam is suggested for episodes of paroxysmal breathlessness. Dose: 0.5mg-1mg sublingually as required (max dose 4mg daily). • In patients unable to tolerate oral medication or those in the dying phase, subcutaneous Midazolam 2.5mg-5mg as required may be appropriate. If effective this can be incorporated into a 24hour subcutaneous infusion via syringe driver. Guidelines Nebulised Medication (Level 4)/(Level 1) NB: The first medication of any nebulised medication, including saline, must be monitored for adverse effect such as bronchospasm. • Nebulised non opioids – Nebulised sodium chloride 0.9% may help as a mucolytic. Consider trial for 24hours. Dose: 5ml via a nebuliser 4 hourly as required. – A trial of nebulised bronchodilator should be considered if there is evidence of airways obstruction (Level 4) commonly prescribed bronchdilators are Salbutamol and Ipratropium Bromide.